50+ ways to rock your Early Intervention Teletherapy sessions

September 8, 2023 Melanie Batista, OTR/L

Becoming comfortable performing Early Intervention teletherapy (or in-person) sessions can take lots of practice and planning. Read on to find inspiration on how to focus your Occupational Therapy, Physical Therapy, or Speech therapy Early Intervention sessions. Parent coach for success and find activity ideas for your littlest learners. Don’t forget your free printables explaining the Early Intervention coaching process to share with your families!

Do you remember your first few months at your first job as an Occupational Therapist?

Remember having little confidence in your skills and working so hard to learn everything you could to help your clients?

My first job as a pediatric Occupational Therapist was at a school working with children with Cerebral Palsy. One of my first clients was a beautiful little girl with athetoid type CP. She was a bright little girl but her extraneous movements and low muscle tone made it so difficult for her to sit, move, and play. She wanted to play and interact with her peers but just couldn’t get her body to cooperate to do so.

When I would look into her eyes I could see her determination to master gravity and I wanted so badly to help her learn to control her body to do the things she wanted to do.

I was a new therapist and just didn’t know where to start to help her. I ended up having a complete meltdown one day in the therapy gym because I felt that I was failing her and myself (It was a professional low!)

Luckily, one of the seasoned physical therapists noticed my breakdown and was there to pick up the pieces and became my mentor for the next several years so I could learn from her expertise.

I know many of you have similar feelings right now being thrown into the world of teletherapy no matter how many years of practice you have under your belt.

There is so much to learn about this new way of practice and mastering the technology piece is enough to make your head spin some days.

Here’s the thing….you already have all you need to be successful!

One of the things that sets us apart from other professions is that we are great problem solvers. We are also great at connecting with others and have an innate desire to help others through difficult times.

I see how hard you are working to find new ways to teach, interact and master this new way of practice and it’s amazing.

But (this is a big BUT!)...Nobody is expecting perfection from you!

You also don’t need to have all the answers to their problems, be the most creative nor have perfectly planned treatment sessions!

Honestly, years down the road, most families won’t remember you because you had the magic solution to their problem, but will remember the connection and compassion you showed their family.

They see that you are working hard, have their best interests at heart and that you are trying to navigate this new way of practice.

Some of the most important things I’ve learned from working in Early Intervention for the past 20 years is that best practice includes keeping it simple, meeting the family where they are at and coaching and collaborating on strategies to support the routines that are important to the family.

What is parent coaching?

According to Rush & Shelden (2005), coaching is an adult learning strategy in which the coach promotes the learner’s ability to reflect on his or her actions as a means to determine the effectiveness of an action or practice and develop a plan for refinement and use of the action in immediate and future situations.

Simply stated, coaching during Early Intervention is a way to educate the caregivers so they can best help their little one grow and learn when you are not there.

I love how Early Intervention teletherapy services lends itself so well to the parent coaching model. It really forces the therapist to take the coach role and puts the caregiver in the driver’s seat.

I have also seen that some families are more willing to try new strategies when the therapist is not physically there in the room. It really does give them so much more confidence in helping their child.

New to Early Intervention or thinking of making the switch to EI from another practice setting? Check out this post!

How to coach during Early Intervention teletherapy sessions

Early Intervention coaching includes five research-based practice characteristics:

Joint plan
This will take place at the beginning of your session. Check in and see what the family has been working on since your last session. It will also happen at the end of your session to recap what will be practiced until they see you again.
Observation
Becoming comfortable with silence on telehealth is important. Making the family feel comfortable that you are observing to offer support not to judge is key. You should be joining in with routines that they were doing before your session started or with another regular routine that they would like support with.
Action/practice
This is where you may teach a skill or have a “coachable moment” (more about that in a little bit). The caregiver tries new strategies with their child to learn or refine a skill.
Reflection
Ask what went well? How did that feel? How do you think your child responded to that? What do you think would have happened if…..? The key in this step is to allow the caregiver time to process.
Feedback
This will most likely occur after the reflection piece to offer tips on which strategies will help the child/family meet their goal. It may also occur during the action/practice stage if something is posing a danger.

Coaching is a complex process that requires training, practice and ongoing reflection.

Nobody is expecting you to become a parent coach overnight. It will definitely take time to perfect and even then there are some families that this approach does not fit.

I know some of you have been conducting sessions in more of a direct way and coaching is new to you.

But I do want you to stop scrolling Pinterest and Facebook till midnight though and get some more rest.

Keep reading for how to get started with parent coaching.

Tips for beginner Parent Coaches

See this content in the original post

Have some ideas for skills to target that are developmentally appropriate for that child. I find that families will often jump to the end goal when asked about skills they want to work on...For example, I hear often “I just want them to talk” or “I just want them to walk”. Usually, though there are many other subskills that child needs to achieve before that big milestone can be accomplished. Educating the family on the subskills needed and the progression leading up to that skill can be very enlightening.

Brush up on your child development in all 5 areas (language, self-care, motor, social-emotional and cognitive). This takes a lot of practice and studying at first. Coaching is all about supporting all areas of development no matter what your discipline is.
Demonstrate fun ways to play with children. This is where we shine! Many parents have a hard time being creative and playful. Having activities demonstrated can be so helpful in sparking interaction with their child. Teletherapy will also force you to be creative and use the materials commonly found in the home.
Check-in with your families often and inquire about other routines during the day where that subskill could be worked on.
Let the family choose which activities they liked or thought were beneficial and which ones they could realistically practice until your next visit. When the family chooses what is important to them they are more likely to practice with their child!
Want to learn more about making the transition from therapist to coach? Check out this post!

Early Intervention Teletherapy Activities

As an experienced Early Intervention provider and coach, I lean on my family and children to lead the sessions.

However, becoming an effective and confident parent coach takes time.

In the beginning, I know you can feel more confident when you have a bag of tricks to fall back on when families are not as engaged as you’d like.

Here are some things to try to bridge the gap between direct intervention and coaching.

Early Intervention Songs

Shake and Move-Patty Shukla

Play with me-Patty Shukla

Simon Says-Patty Shukla

Head Shoulders, Knees and Toes-Patty Shukla

If I were an animal-Patty Shukla

Kilboomers-Freeze Song

Baby Shark Song

We’re going on a bear hunt

How to use:

Play the video on screen to get child participation (for those therapists who are less confident about their singing voices!)
Play the video for the caregiver and then have them try without the screen while you observe.
Learn the song and then model to the family without the video.

Coachable moments:

Teach caregiver where to place hands for body support or to encourage initiation of the movement for their child.
Teach caregiver how to simplify movements or make them more difficult for their child.
Teach caregiver strategies to improve attention-getting down to child’s eye level, give increased time to perform the motion.
Teach caregiver ways to encourage language development of target sound/word.

Early Intervention Book Activities

Very Hungry Caterpillar

Brown Bear, Brown Bear what do you see

Going on a Bear Hunt

Barnyard Dance

How to use:

Play the video and have the child watch
Play the video and have the child and caregiver follow along with their own book (if they have a hard copy)
Have the caregiver read the hard cover book without the screen model.
If you’re looking for a done-for-you resource with book recommendations as well as simple fine motor, gross motor and sensory motor activities perfect for EI teletherapy, check out our book activity bundles in the Growing Little Brains shop.

Coachable moments:

Pair motor movements with certain words in the book. For example, clap hands when you hear the word “boom”.
Instruct caregiver to highlight main words of the book or just describe the picture and not read word for word for younger children.
Teach caregiver to make a request of the child based on the next subskill you are targeting ie. “Point to the cow”, what does the cow say?

Early Intervention Sensory-Motor Activities

Spin in computer chair

Blanket swing (need 2 adults)

Roll in blanket like a burrito

Blanket games

Laundry basket

Scavenger hunts-find something that is red, soft, hard, cold, etc.

Horsey on mommy’s lap

Early Intervention Tactile Activities

Playdough
Shaving cream/Whipped cream or yogurt for littles
Bubbles
Sand
Water-A favorite of mine is to play does it float or sink?

Early Intervention Auditory Activities

Guess the sound

Guess the animal sound

More animal sounds

Early Intervention Visual Activities

Visual closure-Guess the animal game

Visual closure-Guess the animal game 2

Copy simple duplo lego block patterns

How to use:

I love to start sessions with movement for regulation and to prep the child’s body. Movement also creates a connection between caregiver and child and helps to break the ice and set the tone for a playful, fun session.
Ask your families what some of their child’s favorite movement activities are and make a routine of starting with one of them.
Use the auditory links to play name that sound and the visual links to work on visual attention and closure skills.

Coachable moments:

Movement activities are a great way to educate families on the importance of the sensory system for learning and attention.
Have the families verbalize their child’s activity level before, during and after the activity. This is a great way for them to start identifying calming vs. alerting activities.

Empower families to use movement activities throughout the session as needed to calm/alert their child.
Target GM skills-Placing things up high, encourage climbing, squatting, tip toes, half-kneel.

Early Intervention Fingerplay Activities

Open/Shut Them

Ten Little Fingers

Bubble, bubble Pop

MmmAhh went the little green frog

Tiny Tim

Wheels on the Bus

How to use:

There are so many great fingerplays on Youtube.
Use the video to teach your families or model it without the video

Coachable moments:

Encourage new sounds/words
Instruct caregiver hand placement to help child perform motor actions

Early Intervention Fine Motor Activities

Stereognosis challenge:

Place small familiar items into a bag. Have the child take one out without looking and feel the object and tell you what it is

Musical instruments

A good ole fashioned pot and spoon will work well. Have the child copy a beat that the caregiver makes.

Tracing shapes onto paper (any household objects work + matching game)

Cut cereal boxes into puzzles

Tearing paper

Spray bottle activities

Coachable moments:

Build vocabulary, ask/answer questions, motor imitation, facilitating appropriate grasp

Pretend play

Have a stuffed animal party

Dolls

Tea party

Play kitchen/picnic

Doctor/Vet

Trains/Car wash

Coachable moments:

Modeling phrases-targeting vocabulary, increasing length of utterances.
Turn taking-could be with sibling or caregiver.
Following directions-1 step, 2 step, etc.
Practice social-emotional-baby is sad, give her a hug.
Building concepts; Matching colors, targeting same/different, opposites

Now you’ve got lots of ideas to rock your next Early Intervention session. I hope that having some of these go-to ideas will ease your stress a little and give you confidence that you ARE helping these families.

Make sure to check out this post for Teletherapy activities for older children and please share this post to help other therapists that may need some new Early Intervention Teletherapy ideas .